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At the conclusion of the simulation session, learners will be able to: 1) obtain a thorough history relevant to altitude illnesses; 2) develop a differential for dyspnea in a patient with environmental exposures; 3) discuss prophylaxis and management of HAPE; 4) discuss appropriate disposition of the patient including descent and subsequent appropriate level of care.
The primary objective of this course is to provide fourth year medical students an introduction to wilderness medicine. Students will be able to: explain fundamental concepts of practicing medicine in austere conditions; identify and initiate treatment for common wilderness medicine conditions; and utilize the non-medical aspects of providing care in austere environments.
Examination of the skin revealed erythema and induration on the right lateral leg 12 cm in diameter with a 6 cm area of central necrosis and surrounding petechiae without fluctuance or crepitus. The patient was neurovascularly intact distal to the lesion. Laboratory values were within normal limits, except for an elevated C-reactive protein (5.31 mg/dL, normal range <0.70 mg/dL). The patient was diagnosed with ulceration secondary to envenomation from a brown recluse spider.
Through a flipped classroom design, we aim to teach the presentation and management of environmental emergencies, specifically cold related illness, heat related illness, undersea medicine, high altitude medicine, submersion, electrocution, radiation injury, and envenomation. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.
On physical exam, an engorged tick was found attached to the patient’s left upper back. The underlying skin was nontender but mildly erythematous, without central clearing. The tick was gently removed with blunt angle forceps and sent for further analysis, which later revealed the specimen to be an American dog tick (Dermacentor variabilis).